Received: 23 September 2021 | Accepted: 5 November 2021 DOI: 10.1111/wvn.12560 SPECIAL ISSUE Improving hypertension control and cardiovascular health: An urgent call to action for nursing Judith A. Hannan MPH, RN1 | Yvonne Commodore-­Mensah PhD, MHS, RN, FAHA, 2 FPCNA, FAAN | Natsuko Tokieda MPH, RN3 | Alison P. Smith MPH, BA, BSN, RN4 | 5 6 Kate Sustersic Gawlik DNP, RN, APRN-­CNP, FAANP | Linda Murakami MSHA, BSN, RN | 7 Jennifer Cooper DNP, RN, PHNA-­BC, CNE | Susan Koob MPA8 | Kathy D. Wright PhD, RN, APRN-­CNS, PMHCNS-­BC9 | Doreen Cassarino DNP, APRN, 10 FNP-­BC, BC-­ADM, FAANP, FNAP | Cynthia Arslanian-­Engoren PhD, RN, ACNS-­BC, FAHA, FNAP, FAAN11 | Bernadette Mazurek Melnyk PhD, APRN-­CNP, FAANP, FNAP, FAAN12 1 Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Chamblee, Georgia, USA 2 Johns Hopkins School of Nursing, Baltimore, Maryland, USA 3 Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Chamblee, Georgia, USA 4 Target: BP™, American Heart Association/American Medical Association, Chicago, Illinois, USA 5 College of Nursing, The Ohio State University, Columbus, Ohio, USA 6 Practice Facilitation, American Medical Association, Chicago, Illinois, USA 7 Association of Public Health Nurses, Hood College, Fredrick, Maryland, USA 8 Preventive Cardiovascular Nurses Association, Madison, Wisconsin, USA 9 College of Nursing, The Ohio State University, Columbus, Ohio, USA 10 American Association of Nurse Practitioners, Austin, Texas, USA 11 Million Hearts® Sub-­Committee of the American Academy of Nursing Health Behavior Expert Panel, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA 12 The Helene Fuld Health Trust National Institute for EBP, Million Hearts® Sub-­ Committee of the American Academy of Nursing Health Behavior Expert Panel, Abstract Background: Hypertension is a leading cause of cardiovascular disease (CVD) and affects nearly one in two adults in the United States when defined as a blood pressure of at least 130/80 mm Hg or on antihypertensive medication (Virani et al., 2021, Circulation, 143, e254). Long-­standing disparities in hypertension awareness, treatment, and control among racial and ethnic populations exist in the United States. High-­quality evidence exists for how to prevent and control hypertension and for the role nurses can play in this effort. In response to the 2020 Surgeon General's Call to Action to Control Hypertension, nursing leaders from 11 national organizations identified the critical roles and actions of nursing in improving hypertension control and cardiovascular health, focusing on evidence-­based nursing interventions and available resources. Aims: To develop a unified “Call to Action for Nurses” to improve control of hypertension and cardiovascular health and provide information and resources to execute this call. Methods: This paper outlines roles that registered nurses, advanced practice nurses, schools of nursing, professional nursing organizations, quality improvement nurses, and nursing researchers can play to control hypertension and prevent CVD in the United States. It describes evidence-­based interventions to improve cardiovascular health and outlines actions to bring hypertension and CVD to the forefront as a national priority for nursing. Linking Evidence to Action: Evidence-­based interventions exist for nurses to lead efforts to prevent and control hypertension, thus preventing much CVD. Nurses can This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2022 The Authors. Worldviews on Evidence-­based Nursing published by Wiley Periodicals LLC on behalf of Sigma Theta Tau International. This article has been contributed to by US Government employees and their work is in the public domain in the USA. 6 | wileyonlinelibrary.com/journal/wvn Worldv Evid-Based Nu. 2022;19:6–15. The National Forum for Heart Disease and Stroke Prevention, The Ohio State University, Columbus, Ohio, USA Correspondence Judith A. Hannan, Centers for Disease Control and Prevention, 4770 Buford Highway, Chamblee, GA 30341, USA. Email: jat5@cdc.gov | 7 take actions in their communities, their healthcare setting, and their organization to translate these interventions into real-­world practice settings. KEYWORDS blood pressure, blood pressure measurement, cardiovascular disease, cardiovascular health, community interventions, health equity, healthcare disparities, hypertension, lifestyle coaching, nurses I NTRO D U C TI O N Aim Cardiovascular disease (CVD) remains the leading cause of morbid- Within 2 months of the publication of the Surgeon General's Call to ity and mortality for both men and women across the United States Action, individuals from public health nursing, cardiovascular nurs- and worldwide (GBD 2017 Causes of Death Collaborators, 2018). ing, community health center nursing, nursing and medical associa- Hypertension, a leading cause of CVD, affects nearly one in two tions, and academia formed a workgroup to develop a “Call to Action adults in the United States when defined as having a blood pressure for Nurses” to improve control of hypertension and to make sure (BP) of at least 130/80 mm Hg or taking antihypertensive therapy nurses can get the information and resources they need to execute (Virani et al., 2021). Yet, in a recent study, only 77% of individuals this call to action. were aware that they had hypertension, and only 44% of those with Workgroup members reviewed the literature, synthesized the hypertension had their BP controlled to <140/90 mm Hg in 2018 evidence, and made recommendations. This report delineates the (Muntner et al., 2020). Uncontrolled hypertension is an independent critical role of nursing in improving hypertension control in the risk factor for CVD, stroke, kidney disease, and cognitive decline and United States, highlights evidence for nursing interventions to im- significantly contributes to complications of pregnancy and mortal- prove hypertension control and cardiovascular health, and describes ity globally (U.S. Department of Health and Human Services, 2020b; information and resources nurses can use to improve hypertension Whelton et al., 2018; Williamson et al., 2019). control. Hypertension is mostly preventable and controllable (Mills et al., 2020; GBD 2017 Risk Factor Collaborators, 2018). In the United States, progress in improving hypertension control has stalled over the last decade. Without improvements in healthy lifestyle behaviors and healthcare delivery, the decade-­long improvements in A V I S UA L TO O L S H OW I N G S PEC I FI C AC TI O N S TH AT N U R S I N G G RO U P S C A N TA K E cardiovascular health will erode (Kirkland et al., 2018). The ongoing COVID-­19 pandemic has disrupted preventive care and has pre- Figure 1 represents a unifying call to action for all nurses and shows sented barriers to hypertension control, including worsening mental the specific actions that various nursing sectors can take, keep- health and unhealthy coping mechanisms such as unhealthy eating ing the individual with hypertension at the center of their actions. and decreased physical activity (Bhutani et al., 2021; Czeisler et al., Figure 1 provides nurses an easy way to see what each group can do. 2020). Following Figure 1 is detail on the potential actions nurses can take, Long-­standing disparities in hypertension awareness, treatment, broken down by nursing groups or sectors. and control among racial and ethnic populations in the United States must be addressed (Centers for Disease Control and Prevention [CDC], 2021; Commodore-­Mensah et al., 2021; Lackland, 2014). Ample evidence exists for prevention and control of hypertension W H AT TH I S C A LL TO AC TI O N M E A N S FO R R EG I S TE R E D N U R S E S ( R N s) (Appel, 2003; Carey et al., 2018; Whelton et al., 2018), as well as for the role of nurses in preventing and managing hypertension Numbering almost 4 million in the United States, RNs are the larg- (Himmelfarb et al., 2016; Proia et al., 2014). est segment of the healthcare workforce (American Association of In response to the trend of worsening hypertension control, the Colleges of Nursing, 2019) and serve in a wide range of settings: 2020 Surgeon General's Call to Action to Control Hypertension identi- acute care, community health centers, public health agencies, pri- fied three broad goals: (1) Make hypertension a national priority, (2) mary care practices, home health care, nursing homes, and other Ensure places where we live, work, and play support hypertension settings. control, and (3) Optimize patient care for hypertension control (U.S. Department of Health and Human Services, 2020a). Accurate BP measurement, a critical step in hypertension diagnosis and treatment decision, is a fundamental nursing skill. When 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION | Registered Nurses • Measure BP accurately • Provide health coaching • Assess and address SDOH and mental health Design workflow of assessment Paent care/educaon Community-clinical linkage QI / Popula on Health Nurses Advance-Prac ce Registered Nurses • Establish and monitor performance goals • Idenfy gaps in care • Embed guidelines and prompts to promote acon • Diagnose and treat HTN • Intensify treatment • Assess CVD risk Train and empower students and nurses Priori ze HTN Control Schools of Nursing • Ensure BP measurement competence • Teach HTN and CVD risk prevenon and management Advocate evidencebased care/protocols Professional Nursing Organiza ons • Promote evidence-based intervenons • Mobilize members to support HTN policy changes • Advance research Recognize and reward performance BP: Blood Pressure CVD: Cardiovascular Disease HTN: Hypertension QI: Quality Improvement SDOH: Social Determinants of Health F I G U R E 1 Nursing actions to improve hypertension control and CVD risk reduction. Note. BP, blood pressure; CVD, cardiovascular disease; HTN, hypertension; QI, quality improvement; SDOH, social determinants of health RNs do not measure BP accurately, it can lead to over/under diag- Evidence supports self-­measured blood pressure (SMBP) monitor- nosis, over/under-­treatment, or lack of treatment intensification ing (Shimbo et al., 2020), so RNs should educate and motivate patients (Bundy et al., 2017; Johnson et al., 2018; Jones et al., 2003; Piper to self-­monitor their BP. This includes the following: et al., 2015). The most common cause of clinical inertia (i.e., failure of a clinician to intensify treatment) is the concern that a BP is not representative of a patient's true BP, either because it is inaccurately measured or because of an insufficient number of readings. Thus, RNs need to be meticulous about accurate BP measurement, • Teaching patients to accurately use and calibrate their home BP monitors (Parati et al., 2021). • Using motivational interviewing in serving as a health coach (Hickey et al., 2019). whether using a manual or an automated BP cuff (Muntner et al., 2019). Specific actions for RNs include the following: RNs can refer patients to evidence-­based programs for preventing or managing chronic disease such as Stanford's Chronic Disease Self-­Management Education (Administration for Community Living, • Be re-­skilled every 6–­12 months as recommended by the 2019 American Heart Association (AHA) Scientific Statement on the Measurement of BP in Humans (Muntner et al., 2019). • Ensure proper positioning of patients in a supportive chair (rather than on an exam table). • Ensure that the environment allows an accurate measurement (Pickering et al., 2005). • Educate certified nursing assistants, medical assistants, and others in accurate BP measurement and technique (Block et al., 2018). 2021), the CDC’s National Diabetes Prevention Program (CDC, 2019), and others. RNs can identify social and structural determinants of health that are barriers to seeking preventive screenings and health care. For Black or African American adults, the experience of racial discrimination increases the incidence of hypertension by 50% (Forde et al., 2020). Black or African American adults are more likely to have uncontrolled hypertension than other racial and ethnic groups (Carnethon et al., 2017). Black or African American and • In practice settings, develop protocols for when and how BP is Hispanic adults have a higher lifetime risk of hypertension than measured and address abnormal results during healthcare en- White adults (Carson et al., 2011; Fryar et al., 2017). Nearly 50% of counters (Josiah Macy Jr. Foundation, 2017). Black or African American women with uncontrolled hypertension • In the community, collaborate with businesses, pharmacies, and payers to ensure BP monitors and screening locations are available outside of the healthcare setting. • Review data from electronic health records to identify and address untreated or uncontrolled BP. have depression (Gabriel et al., 2021). RNs can address social determinants of health (SDOHs) that affect hypertension, including access to transportation, health care, medication, safe places to exercise, and nutritious food. They can: 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 8 • Establish open clinic hours so that patients who rely on public | 9 • Regularly assessing for side effects of hypertension medication, transportation will not be penalized for late clinic appointments. adherence to antihypertensive therapy, and lifestyle changes. • Screen for SDOH using the accountable health communi- • Educating colleagues who measure BP in their clinics to ensure ties screening tool (Billioux et al., 2017; Casey et al., 2019); the accurate BP measurement. Protocol for Responding to and Assessing Patients' Risks, Assets, and Experiences (Weir et al., 2020); or other standardized screening tools. • Work with local partners such as community health workers, so- W H AT TH I S C A LL TO AC TI O N M E A N S FO R SCHOOLS OF NURSING cial service, and other community-­based support agencies that are poised to help address SDOH. Schools of nursing must ensure their graduates can execute the afore- • Establish an inventory of the above local community resources mentioned strategies designed to improve BP control. They should that promote clinical and community linkages and advance health teach the importance of early and accurate diagnosis, evidence-­based equity (Ibe et al., 2021). healthy lifestyle interventions, behavior change strategies to prevent CVD, assessments and steps for addressing SDOH, and team-­based Attending to the above actions, RNs will be influencing more care. Specific actions for schools of nursing include the following: than control of hypertension, as such initiatives can help eliminate health disparities. • Teaching accurate BP measurement at multiple points across curricula. W H AT TH I S C A LL TO AC TI O N M E A N S FO R A DVA N C E D - ­P R AC TI C E R EG I S TE R E D N U R S E S ( A PR N s) • Ensuring competence of students in conducting cardiovascular and mental health assessments. • Incorporating the latest evidence-­based guidelines on exercise, nutrition, wellness, stress, anxiety and depression management, and BP diagnosis and management. Nurse practitioners (NPs) are advanced practice RNs (APRNs) • Teaching RNs and APRNs to incorporate SMBP monitoring and who blend clinical expertise in diagnosing and treating health healthy lifestyle prescriptions into patient care and management. conditions, including hypertension, with an emphasis on disease • Preparing nurses to educate patients about their CV risks, diagno- prevention and providing health education, health coaching, and sis of hypertension, treatment regimen, and adherence strategies. counseling to their patients. As of December 2020, more than • Enable students and nurses to exercise, choose healthy foods, 325,000 NPs were licensed to practice in the United States, and get care for mental health concerns. providing more than 1 billion patient visits each year (American • Integrating the Million Hearts® Fellowship module in nursing ed- Association of Nurse Practitioners, 2021). Specific actions for ucation and public health nursing and providing students with APRNs include the following: hands-­on experience in cardiovascular screenings and cardiovascular risk reduction counseling (Gawlik & Melnyk, 2015). • Routinely screening and diagnosing hypertension through accurate BP measurement. • Including team-­based care, evidence-­based quality improvement, and population health management techniques in nursing curricula. • Providing patient education on the importance of hypertension • Implementing a standardized, evidence-­based treatment protocol prevention, control, and evidenced-­based ways to adopt and sus- that university health centers can use to identify and treat faculty, tain a heart-­healthy lifestyle. staff, and students with hypertension. • Prescribing antihypertensive medications using established • Teaching about SDOHs and their role on cardiovascular out- guidelines such as the 2017 ACC/AHA Hypertension Guideline comes, how to complete a SDOH screening, and how to find and (Whelton et al., 2018). connect patients to local community resources. • Routinely screening for and providing early evidence-­based • Examining the impact of structural racism/discrimination on hyper- interventions for depression and anxiety/stress given the evi- tension control and mitigation of unconscious bias in the healthcare dence showing the association between these factors and CVD (Gawlik et al., 2019; Giannoglou & Koskinas, 2015; Levine et al., 2021). • Screening for other common comorbidities such as diabetes and initiating evidence-­based treatment regimens as needed. • Using motivational interviewing to assist patients with healthy lifestyle behavior change (Sawyer et al., 2020). setting. • Incorporating the assessment of depression and anxiety into curricula because these can be barriers to hypertension control. • Emphasizing population health cardiovascular prevention including community-­based interventions, such as establishing walkable communities, and access to healthy food options. • Teaching students how to stay current on the best and latest evi- • Ensuring adequate treatment, timely follow-­up, treatment inten- dence to prevent and manage hypertension and CVD through ed- sification, and, if needed, referrals to specialists until BP goals are ucation and skills building in evidence-­based practice (Melnyk & reached. Fineout-­Overholt, 2019). 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION | IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION • Ensuring that students meet the evidence-­based practice competencies for RNs and APRNs by the time they graduate from their academic programs (Melnyk et al., 2014, 2016). • Integrating hypertension diagnosis and management curricula into continuing education programming. • Reinforcing BP measurement competency through training and certification programs every 6–­12 months. W H AT TH I S C A LL TO AC TI O N M E A N S FO R PRO FE S S I O N A L N U R S I N G O RG A N IZ ATI O N S • Generating and supporting national campaigns to educate the public on hypertension management and prevention of CVD. • Championing and encouraging insurers to consider covering services related to heart health. These include the following: Professional nursing organizations are crucial to improving hy- • Coverage of validated SMBP devices. pertension control and promoting overall cardiovascular health. • Coverage of medication, including combination pills. These organizations include the American Nurses Association, the • Reimbursement for patient education regarding diagnosis, medi- American Academy of Nursing, the Preventive Cardiovascular Nurses cation use, SMBP monitoring training for technique, and reporting Association, the National Black Nurses Association, the American results back to clinician, including technology assistance if needed. Association of Nurse Practitioners, and CV nursing affinity groups like • Coverage of lifestyle change programs. the AHA Council on Cardiovascular and Stroke Nursing, among others. • BP rechecks without co-­pay. Professional nursing associations’ members can help influence their • Synchronization of and multi-­month medication refills without healthcare organizations and communities by sharing messaging to improve hypertension prevention, diagnosis, and treatment through education and leadership. These organizations also should prioritize additional co-­pays. • Reimbursement for cardiovascular risk reduction education by nurses. actions supporting nurses adopting healthier lifestyles and attending to their cardiovascular health. Specific actions for professional nursing organizations include the following: • Making the topic of cardiovascular health a priority for national W H AT TH I S C A LL TO AC TI O N M E A N S FO R E V I D E N C E- ­B A S E D Q UA LIT Y I M PROV E M E NT A N D P O PU L ATI O N H E A LTH N U R S E S conferences and meetings. • At meetings, allowing for frequent recovery breaks and movement and encouraging healthy meals and snacks. • Encouraging nurses to make healthy lifestyle choices and to prioritize self-­care. With additional education and skills in evidence-­based quality improvement (EBQI) and population health, nurses can play a pivotal role in improving BP control within healthcare systems or populations using data to drive lasting change (Melnyk et al., 2015; Melnyk & Morrison-­Beedy, • Promoting evidence-­based interventions and strategies to im- 2019). Nurses can do this using clinical practice facilitation within a prove hypertension diagnosis and management as well as cardio- specific ambulatory care setting, managerial EBQI roles within a health vascular risk reduction. system, population management programs through a payer or EBQI col- • Encouraging members to be leaders in advocating for community laborative, and public health initiatives at the local, state, and national interventions that lead to better cardiovascular health, such as level. Regardless of the level of involvement, nurses are skilled in team-­ those found in the “Guide to Community Preventive Services” based care and EBQI principles requiring them to identify and engage (Community Preventive Services Task Force, n.d.). leadership, clinical champions, and other colleagues—­including primary • Showcasing best practice protocols for hypertension control in newsletters, journals, and other publications. • Developing programs that recognize and reward nursing actions to improve hypertension control. care nurses connecting to specialty care nurses and nurses connecting to colleagues from medicine, pharmacy, social work, biomedical engineering, health information technology, and other stakeholders. With the support from leadership making hypertension control • Creating and disseminating educational resources on the pre- an institutional priority and engaging a team of supportive stake- vention, diagnosis, and treatment of hypertension to be used by holders, health systems can equip EBQI nurses with evidence-­based healthcare professionals and patients. tools and resources to drive practice change and improve patient • Educating nurses on SDOHs and barriers to care that affect people's ability to prevent, diagnose, treat, and manage their hypertension. • Developing evidence-­based interventions to mitigate racism, dis- outcomes (Casey et al., 2021). Examples of evidence-­based tools can be found in Tables S2–­S5. Specific actions that EBQI nurses can take include the following: crimination, and structural racism in the healthcare setting, such as reviewing historical practices and policies to ensure all patients are treated equally. • Supporting initiatives to educate members, patients, and the general public on hypertension control and lifestyle choices that promote health. • Advancing research in hypertension prevention and treatment. • Using practice data, such as a hypertension registry (Whelton et al., 2018), to quantify gaps in care and establish baseline performance for indicators such as follows: • Rates of hypertension control, including rates by subpopulation such as gender, race and ethnicity, or age, as well as by individual clinician or care location. 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 10 • Frequency of follow-­up visits for patients with uncontrolled hypertension. • Rates of treatment intensification for patients with uncontrolled hypertension. • Rates of lifestyle interventions. • Rates of response to treatment for patients who have had a | 11 importance of conducting research to increase knowledge of nursing interventions targeted at improving hypertension control (National Institutes of Health, 1976). Nurses have since led trials that have provided the evidence base for clinical practice and trials focused on community-­based interventions to improve hypertension control. Exemplars of nurse-­led clinical trials to improve hypertension change in their treatment. control include the Community Outreach and Cardiovascular Health • Rates of medication refills. Trial (Allen et al., 2011), Nurse-­Managed BP Telemonitoring Among • Reporting on the frequency with which patients are using Urban African Americans (Artinian et al., 2007), and the Self-­Help SMBP measurement. Intervention Program for High Blood Pressure Care (Kim et al., 2011). • Establishing and monitoring performance goals, including per- Several hypertension trials have included a nursing intervention formance, process quality, and structural measures (Casey et al., as part of a multi-­component intervention, as described in Table S1. 2019), such as follows: • Performance measures, including control rates at various stages of hypertension. • Process quality measures, including intervention, adherence, and use of SMBP. Nurse researchers should address current challenges in cardiovascular health and hypertension control, prioritizing research where there is not enough evidence to guide practice. Nursing researchers should also collaborate with nursing faculty and Doctor of Nursing Practice prepared nurses to ensure research findings are implemented • Structural measures including use of standardized protocols for into clinical practice without delay. This research-­practice time gap is measurement accuracy, Atherosclerotic Cardiovascular Disease estimated to be 15 years (Khan et al., 2021). Priority topics for car- risk assessment, shared decision-­making, and team-­based care. diovascular and hypertension research should include the following: • Elevating clinical practice guidelines and evidence to drive continuing professional education, policies, and protocols (Whelton et al., 2018). • Embedding evidence-­based guidelines and prompt adherence to protocols like confirmatory measurements and treatment inten- • Lifestyle interventions to prevent the development of hypertension in high-­risk populations. • Interventions to reduce anxiety, stress, and depression in people with CVD. sification for patients with uncontrolled BP in health information • Examination of underlying mechanisms of health behavior change. technology (Whelton et al., 2018). A nursing informaticist is well-­ • Culturally informed interventions to promote healthy behaviors. suited for this role. • Developing and testing interventions to improve hypertension • Facilitating team huddles to identify patients with uncontrolled BP and considering assessments and interventions to achieve BP goals. control and cardiovascular risk, including healthy lifestyle behavior change. • Health disparities and CVD. • Educating care teams on evidence-­based care. • Maternal health interventions to promote cardiovascular health. • Serving as clinical practice facilitators coaching care teams in am- • Interventions that address SDOHs and improve hypertension bulatory care settings to adopt and adhere to evidence-­based, systematic care practices. control. • SMBP monitoring to reduce hypertension disparities. • Interventions to mitigate structural racism and discrimination to Evidence of nurses playing a role in EBQI includes examples such as follows: increase access to care. • Ways that informatics nurses, statisticians, and computer scientists can work together to turn big data into information that can • Implementation of nurse-­led community-­based chronic disease management models to engage low-­income urban residents in BP management (Sanders & Guse, 2017). • Dissemination of SMBP monitoring protocols to patients to assure accurate BP measurement in the home (Parati et al., 2021). be translated into nursing practice. • Dissemination and implementation of studies to speed the translation of evidence-­based interventions to control hypertension and prevent CVD into real-­world clinical settings. • How structural racism contributes to poor hypertension control and cardiovascular health and interventions to mitigate the ef- CO NTR I B U TI O N S FRO M A N D CO N S I D E R ATI O N S FO R N U R S E R E S E A RC H E R S fects of structural racism. R E S O U RC E S TH AT N U R S E S FRO M A LL S EC TO R S C A N U S E Nurse researchers play an essential role in designing and conducting trials to improve hypertension outcomes. In 1976, the Taskforce Preventing hypertension and improving hypertension control is well on the Role of Nursing in High Blood Pressure Control affirmed the understood. Over the last decade, nurses have been the source of 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION | major national organizations and initiatives to improve prevention • Improving food purchasing practices and walkability of communi- and control of hypertension. These organizations and initiatives ties are important to general health and to preventing and manag- provide tools and resources to improve control of hypertension; this paper presents these resources. Million Hearts® is a national initiative co-­led by the CDC and Centers for Medicare & Medicaid Services to prevent 1 million heart attacks, strokes, and other cardiovascular events over a 5-­year pe- ing hypertension. • Assessing and addressing SDOHs and psychological health can reduce health disparities in vulnerable populations. • Nurses should ensure accuracy of BP measurement, as this is a critical step in hypertension diagnosis, treatment, and control. riod. It focuses on implementing a small set of evidence-­based prior- • Patients should be taught to measure their BP. ities and targets that can improve cardiovascular health for all. The • Evidence-­based guideline-­recommended care, comprehensive ® Million Hearts website offers numerous tools for patients and pro- treatment protocols, self-­measured blood pressure monitoring, viders and describes evidence-­based strategies to decrease physi- and team-­based care are all important. cal inactivity, tobacco use, and salt intake. It outlines care changes needed to improve use of aspirin as appropriate, BP control, cholesterol management, and smoking cessation. It lists key actions CO N C LU S I O N S needed to improve outcomes of specific priority populations. Nurses can join partner meetings and specific forums and read newsletters Uncontrolled hypertension causes CVD, stroke, and kidney disease, on the site. among other health problems, which cause unnecessary human suf- Target: BP™ is a national initiative of the American Heart fering and premature death. Disparities in hypertension diagnosis, Association and the American Medical Association (AMA) in re- treatment, and control among racial and ethnic groups in the United sponse to the high prevalence of uncontrolled BP. It helps healthcare States should be addressed. We know what to do to prevent the organizations and care teams, at no cost, improve BP control rates development of hypertension, detect it early, and control it, yet, as a through an evidence-­based quality improvement program and rec- nation, we are not succeeding. Nurses are well positioned to contrib- ognizes organizations committed to improving BP control. ute meaningfully to national efforts to improve hypertension con- The Preventive Cardiovascular Nurses Association (PCNA) is a nursing organization preventing cardiovascular disease through as- trol, using the ample evidence on how to prevent, diagnose, treat, and control hypertension. sessing risk, facilitating lifestyle changes, and guiding individuals to The COVID-­19 pandemic has placed demands on nurses and the achieve treatment goals. PCNA is committed to the continued ed- nursing profession, but as nurses, we know that our colleagues, fac- ucation and support of nurses so they may successfully rise to this ulty, and students can still be inspired by a new call to action to save challenge. PCNA offers a Cardiovascular Nursing Certificate program lives. Our ask is to use the evidence and resources and seize opportu- and numerous resources for patient education and for providers. nities to act. More information about how to join with other nurses in The AMA leads and participates in numerous efforts to improve this call to action can be found at https://millionhearts.hhs.gov/. control of hypertension. Their “About Improving Health Outcomes” web page has specific BP resources to assist healthcare practices ORCID https://orcid.org/0000-0002-9118-5279 and clinicians in building a team to focus on hypertension to measure Judith A. Hannan accurately, act rapidly, partner with patients, and promote appropri- Yvonne Commodore-­Mensah ate use of SMBP monitoring. org/0000-0002-5054-3025 The websites of all four of these organizations offer numerous Natsuko Tokieda https://orcid. https://orcid.org/0000-0002-0358-5636 https://orcid.org/0000-0002-3298-4409 tools to assist nurses. Tables S2–­S5 provide detailed lists and links to Alison P. Smith specific resources from these and other organizations sorted by the Kate Sustersic Gawlik three goals of the Surgeon General's Call to Action: (1) Make hyper- Jennifer Cooper https://orcid.org/0000-0002-0255-6091 tension control a national priority, (2) Cultivate community supports, Kathy D. Wright https://orcid.org/0000-0001-7346-1981 and (3) Optimize patient care for hypertension. Given the need for all Doreen Cassarino nurses to be able to provide an accurate assessment of BP, we included Cynthia Arslanian-­Engoren https://orcid.org/0000-0002-4468-1093 a fourth table with resources specific to accurate measurement. Bernadette Mazurek Melnyk https://orcid.org/0000-0002-4704-1198 LI N K I N G E V I D E N C E TO AC TI O N • Nurses in all settings should emphasize lifestyle modification, an evidence-­based strategy to prevent, treat, and control hypertension. • Nurses should link patients to peer support programs for physical activity and nutrition or advocate for others to do so. https://orcid.org/0000-0001-5809-2495 https://orcid.org/0000-0003-4057-4140 REFERENCES Administration for Community Living. (2021) Chronic disease self-­ management education programs. Available at: https://acl.gov/progr ams/health -­w ellne ss/chroni c-­d iseas e-­s elf-­m anage ment- ­e duca tion-­programs [Accessed 8 September 2021]. Allen, J.K., Dennison-­H immelfarb, C.R., Szanton, S.L., Bone, L., Hill, M.N., Levine, D.M. et al. (2011) Community Outreach and Cardiovascular Health (COACH) trial: a randomized, controlled trial of nurse practitioner/community health worker 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 12 cardiovascular disease risk reduction in urban community health centers. Circulation. Cardiovascular Quality and Outcomes, 4(6), 595–­6 02. Available from: https://doi.org/10.1161/circou tcom es.111.961573 American Association of Colleges of Nursing. (2019) Nursing fact sheet. Available at: https://www.aacnnursing.org/news-­Information/ fact-­sheets/nursing-­fact-­sheet [Accessed 8 September 2021]. American Association of Nurse Practitioners. (2021) More than 325,000 nurse practitioners (NPs) licensed in the United States. Available at: https://www.aanp.org/news-­f eed/more-­t han-­3 25-­0 00-­n urse -­practitioners-­nps-­licensed-­in-­the-­united-­states [Accessed 8 September 2021]. Appel, L.J. (2003) Lifestyle modification as a means to prevent and treat high blood pressure. Journal of the American Society of Nephrology, 14(7 Suppl. 2), S99–­S102. Available from: https://doi. org/10.1097/01.asn.0000070141.69483.5a Artinian, N.T., Flack, J.M., Nordstrom, C.K., Hockman, E.M., Washington, O.G., Jen, K.L. et al. (2007) Effects of nurse-­managed telemonitoring on blood pressure at 12-­month follow-­up among urban African Americans. Nursing Research, 56(5), 312–­322. Available from: https://doi.org/10.1097/01.NNR.0000289501.45284.6e Bhutani, S., vanDellen, M.R. & Cooper, J.A. (2021) Longitudinal weight gain and related risk behaviors during the COVID-­19 pandemic in adults in the US. Nutrients, 13(2), 671. Available from: https://doi. org/10.3390/nu13020671 Billioux, A., Verlander, K., Anthony, S. & Alley, D. (2017) Standardized screening for health-­related social needs in clinical settings: the Accountable Health Communities Screening Tool. NAM Perspectives, 7(5), 1–­9. Available from: https://doi.org/10.31478/ 201705b Block, L., Flynn, S.J., Cooper, L.A., Lentz, C., Hull, T., Dietz, K.B. et al. (2018) Promoting sustainability in quality improvement: an evaluation of a web-­based continuing education program in blood pressure measurement. BMC Family Practice, 19(1), 13. Available from: https://doi.org/10.1186/s12875-­017-­0682-­5 Bundy, J.D., Li, C., Stuchlik, P., Bu, X., Kelly, T.N., Mills, K.T. et al. (2017) Systolic blood pressure reduction and risk of cardiovascular disease and mortality: a systematic review and network meta-­analysis. JAMA Cardiology, 2(7), 775–­781. Available from: https://doi. org/10.1001/jamacardio.2017.1421 Carey, R.M., Muntner, P., Bosworth, H.B. & Whelton, P.K. (2018) Prevention and control of hypertension: JACC health promotion series. Journal of the American College of Cardiology, 72(11), 1278–­1293. Available from: https://doi.org/10.1016/j. jacc.2018.07.008 Carnethon, M.R., Pu, J., Howard, G., Albert, M.A., Anderson, C.A.M., Bertoni, A.G. et al. (2017) Cardiovascular health in African Americans: a scientific statement from the American Heart Association. Circulation, 136(21), e393–­e 423. Available from: https://doi.org/10.1161/cir.000000 00000 00534 Carson, A.P., Howard, G., Burke, G.L., Shea, S., Levitan, E.B. & Muntner, P. (2011) Ethnic differences in hypertension incidence among middle-­aged and older adults: the multi-­ethnic study of atherosclerosis. Hypertension, 57(6), 1101–­1107. Available from: https://doi. org/10.1161/HYPERTENSIONAHA.110.168005 Casey, D.E., Daniel, D.M., Bhatt, J., Carey, R.M., Commodore-­Mensah, Y., Holmes, A. et al. (2021) Controlling high blood pressure: an evidence-­based blueprint for change. American Journal of Medical Quality. Advanced online publication. Available from: https://doi. org/10.1097/01.Jmq.0000749856.90491.43 Casey, D.E., Thomas, R.J., Bhalla, V., Commodore-­M ensah, Y., Heidenreich, P.A., Kolte, D. et al. (2019) 2019 AHA/ACC clinical performance and quality measures for adults with high blood pressure: a report of the American College of Cardiology/ American Heart Association Task Force on performance measures. Circulation. Cardiovascular Quality and Outcomes, 12(11), | 13 e000057. Available from: https://doi.org/10.1161/hcq.00000 000000 00057 Centers for Disease Control and Prevention. (2019) National diabetes prevention program. Available at: https://www.cdc.gov/diabetes/preve ntion/index.html [Accessed 8 September 2021]. Centers for Disease Control and Prevention. (2021) Hypertension cascade: hypertension prevalence, treatment and control estimates among US adults aged 18 years and older applying the criteria from the American College of Cardiology and American Heart Association’s 2017 Hypertension Guideline—­ NHANES 2015–­ 2018. Available at: https://millio nhear ts.hhs.gov/data-­r eport s/hypert ensio n-­p reva lence.html [Accessed 8 September 2021]. Commodore-­Mensah, Y., Turkson-­Ocran, R.A., Foti, K., Cooper, L.A. & Himmelfarb, C.D. (2021) Associations between social determinants and hypertension, stage 2 hypertension and controlled blood pressure among men and women in the US. American Journal of Hypertension, 34(7), 707–­717. Available from: https://doi. org/10.1093/ajh/hpab011 Community Preventive Services Task Force. (n.d.). The Community Guide. The guide to community preventive services. Available at: https:// www.thecommunit yguide.org/ [Accessed 8 September 2021]. Czeisler, M.É., Lane, R.I., Petrosky, E., Wiley, J.F., Christensen, A., Njai, R. et al. (2020) Mental health, substance use, and suicidal ideation during the COVID-­19 pandemic –­United States, June 24–­3 0, 2020. Morbidity and Mortality Weekly Report, 69(32), 1049–­1057. Available from: https://doi.org/10.15585/mmwr.mm6932a1 Forde, A.T., Sims, M., Muntner, P., Lewis, T., Onwuka, A., Moore, K. et al. (2020) Discrimination and hypertension risk among African Americans in the Jackson heart study. Hypertension, 76(3), 715–­723. Available from: https://doi.org/10.1161/hypertensi onaha.119.14492 Fryar, C.D., Ostchega, Y., Hales, C.M., Zhang, G. & Kruszon-­Moran, D. (2017) Hypertension prevalence and control among adults: United States, 2015–­2016 (NCHS Data Brief No. 289). Available at: https:// www.cdc.gov/nchs/data/databriefs/db289.pdf [Accessed 8 September 2021]. Gabriel, A., Zare, H., Jones, W., Yang, M., Ibe, C.A., Cao, Y. et al. (2021) Evaluating depressive symptoms among low-­socioeconomic-­status African American women aged 40 to 75 years with uncontrolled hypertension: a secondary analysis of a randomized clinical trial. JAMA Psychiatry, 78(4), 426–­432. Available from: https://doi. org/10.1001/jamapsychiatry.2020.4622 Gawlik, K.S. & Melnyk, B.M. (2015) Integrating Million Hearts into nursing and interprofessional educational curricula and community settings: a key strategy for improving population health across the United States. Journal of Professional Nursing, 31(2), 112–­118. Available from: https://doi.org/10.1016/j.profnurs.2014.07.002 Gawlik, K.S., Melnyk, B.M. & Tan, A. (2019) Associations between stress and cardiovascular disease risk factors among Million Hearts priority populations. American Journal of Health Promotion, 33(7), 1063–­ 1066. Available from: https://doi.org/10.1177/08901171198 47619 Giannoglou, G.D. & Koskinas, K.C. (2015) Mental stress and cardiovascular disease: growing evidence into the complex interrelation between mind and heart. Angiology, 66(1), 5–­7. Available from: https:// doi.org/10.1177/0003319714525032 Hickey, K., Wan, E., Garan, H., Biviano, A., Morrow, J., Siacca, R. et al. (2019) A nurse-­led approach to improving cardiac lifestyle modification in an atrial fibrillation population. The Journal of Innovations in Cardiac Rhythm Management, 10(9), 3826–­3835. Available from: https://doi.org/10.19102/icrm.2019.100902 Himmelfarb, C.R., Commodore-­Mensah, Y. & Hill, M.N. (2016) Expanding the role of nurses to improve hypertension care and control globally. Annals of Global Health, 82(2), 243–­253. Available from: https:// doi.org/10.1016/j.aogh.2016.02.003 Ibe, C.A., Hickman, D. & Cooper, L.A. (2021) To advance health equity during COVID-­19 and beyond, elevate and support community 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION | IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION health workers. JAMA Health Forum, 2(7), e212724. Available from: https://doi.org/10.1001/jamahealthforum.2021.2724 Johnson, K.C., Whelton, P.K., Cushman, W.C., Cutler, J.A., Evans, G.W., Snyder, J.K. et al. (2018) Blood pressure measurement in SPRINT (Systolic Blood Pressure Intervention Trial). Hypertension, 71(5), 848–­857. Available from: https://doi.org/10.1161/hypertensi onaha.117.10479 Jones, D.W., Appel, L.J., Sheps, S.G., Roccella, E.J. & Lenfant, C. (2003) Measuring blood pressure accurately: new and persistent challenges. JAMA, 289(8), 1027–­1030. Available from: https://doi. org/10.1001/jama.289.8.1027 Josiah Macy Jr. Foundation. (2017) Registered nurses: partners in transforming primary care, proceedings of a conference on preparing registered nurses for enhanced roles in primary care. Available at: https:// macyfo undat ion.org/assets/report s/public ation s/macy_monog raph_nurses_2016_webpdf.pdf [Accessed 8 September 2021]. Khan, S., Chambers, D. & Neta, G. (2021) Revisiting time to translation: implementation of evidence-­based practices (EBPs) in cancer control. Cancer Causes & Control, 32(3), 221–­230. Available from: https://doi.org/10.1007/s10552-­020-­01376-­z Kim, M.T., Han, H.R., Hedlin, H., Kim, J., Song, H.J., Kim, K.B. et al. (2011) Teletransmitted monitoring of blood pressure and bilingual nurse counseling-­sustained improvements in blood pressure control during 12 months in hypertensive Korean Americans. Journal of Clinical Hypertension, 13(8), 605–­612. Available from: https://doi. org/10.1111/j.1751-­7176.2011.00479.x Kirkland, E.B., Heincelman, M., Bishu, K.G., Schumann, S.O., Schreiner, A., Axon, R.N. et al. (2018) Trends in healthcare expenditures among US adults with hypertension: national estimates, 2003–­ 2014. Journal of the American Heart Association, 7(11), 2003–­2014. Available from: https://doi.org/10.1161/JAHA.118.008731 Lackland, D.T. (2014) Racial differences in hypertension: implications for high blood pressure management. The American Journal of the Medical Sciences, 348(2), 135–­138. Available from: https://doi. org/10.1097/maj.000000 00000 00308 Levine, G.N., Cohen, B.E., Commodore-­Mensah, Y., Fleury, J., Huffman, J.C., Khalid, U. et al. (2021) Psychological health, well-­being, and the mind-­heart-­body connection: a scientific statement from the American Heart Association. Circulation, 143(10). Available from: e763–­e783. https://doi.org/10.1161/cir.000000 00000 00947 Melnyk, B.M., Buck, J. & Gallagher-­Ford, L. (2015) Transforming quality improvement into evidence-­based quality improvement: a key solution to improve healthcare outcomes. Worldviews on Evidence-­Based Nursing, 12(5), 251–­252. Available from: https://doi.org/10.1111/ wvn.12112 Melnyk, B.M. & Fineout-­Overholt, E. (2019) Evidence-­based practice in nursing and healthcare: a guide to best practice, 4th edition. Philadelphia, PA: Wolters Kluwer/Lippincott, Williams & Wilkins. Melnyk, B.M., Gallagher-­Ford, L., Long, L.E. & Fineout-­Overholt, E. (2014) The establishment of evidence-­based practice competencies for practicing registered nurses and advanced practice nurses in real-­world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-­Based Nursing, 11(1), 5–­15. Available from: https://doi. org/10.1111/wvn.12021 Melnyk, B.M., Gallagher-­Ford, L. & Fineout-­Overholt, L.E. (2016) Implementing the evidence-­ based practice (EBP) competencies in healthcare: a practical guide for improving quality, safety, and outcomes. Indianapolis, IN: Sigma Theta Tau International. Melnyk, B.M. & Morrison-­Beedy, D. (2019) Intervention research and evidence-­based quality improvement, 2nd edition. New York, NY: Springer Publishing Company. Mills, K.T., Stefanescu, A. & He, J. (2020) The global epidemiology of hypertension. Nature Reviews. Nephrology, 16(4), 223–­237. Available from: https://doi.org/10.1038/s41581-­019-­0244-­2 Muntner, P., Hardy, S.T., Fine, L.J., Jaeger, B.C., Wozniak, G., Levitan, E.B. et al. (2020) Trends in blood pressure control among US adults with hypertension, 1999–­2000 to 2017–­2018. JAMA, 324(12), 1190–­ 1200. Available from: https://doi.org/10.1001/jama.2020.14545 Muntner, P., Shimbo, D., Carey, R.M., Charleston, J.B., Gaillard, T., Misra, S. et al. (2019) Measurement of blood pressure in humans: a scientific statement from the American Heart Association. Hypertension, 73(5), e35–­e66. Available from: https://doi.org/10.1161/ hyp.000000 00000 00087 National Institutes of Health. (1976) Nursing education in high blood pressure control, report of the task force on the role of nursing in high blood pressure control. Available at: https://files.eric.ed.gov/fulltext/ ED140036.pdf [Accessed 8 September 2021]. Parati, G., Stergiou, G.S., Bilo, G., Kollias, A., Pengo, M., Ochoa, J.E. et al. (2021) Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension. Journal of Hypertension, 39(9), 1742–­1767. Available from: https://doi. org/10.1097/hjh.000000 00000 02922 Pickering, T.G., Hall, J.E., Appel, L.J., Falkner, B.E., Graves, J., Hill, M.N. et al. (2005) Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation, 111(5), 697–­716. Available from: https://doi. org/10.1161/01.Cir.0000154900.76284.F6 Piper, M.A., Evans, C.V., Burda, B.U., Margolis, K.L., O'Connor, E. & Whitlock, E.P. (2015) Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: a systematic review for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 162(3), 192–­204. Available from: https://doi.org/10.7326/m14-­1539 Proia, K.K., Thota, A.B., Njie, G.J., Finnie, R.K.C., Hopkins, D.P., Mukhtar, Q. et al. (2014) Team-­based care and improved blood pressure control: a community guide systematic review. American Journal of Preventive Medicine, 47(1), 86–­99. Available from: https://doi. org/10.1016/j.amepre.2014.03.004 Roth, G.A., Abate, D., Abate, K.H., Abay, S.M., Abbafati, C., Abbasi, N. et al. (2018) Global, regional, and national age-­sex-­specific mortality for 282 causes of death in 195 countries and territories, 1980–­ 2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392(10159), 1736–­1788. Available from: https://doi. org/10.1016/s0140-­6736(18)32203-­7 Sanders, J. & Guse, C.E. (2017) Reaching urban poor hypertensive patients: a novel model of chronic disease care versus a traditional fee-­for-­service approach. Journal of Primary Care & Community Health, 8(1), 14–­19. Available from: https://doi.org/10.1177/21501 31916662465 Sawyer, A.T., Wheeler, J., Jennelle, P., Pepe, J. & Robinson, P.S. (2020) A randomized controlled trial of a motivational interviewing intervention to improve whole-­person lifestyle. Journal of Primary Care & Community Health, 11, 2150132720922714. Available from: https://doi.org/10.1177/2150132720922714 Shimbo, D., Artinian, N.T., Basile, J.N., Krakoff, L.R., Margolis, K.L., Rakotz, M.K. et al. (2020) Self-­measured blood pressure monitoring at home: a joint policy statement from the American Heart Association and American Medical Association. Circulation, 142(4), e42–­e63. Available from: https://doi.org/10.1161/cir.0000000000000803 Stanaway, J.D., Afshin, A., Gakidou, E., Lim, S.S., Abate, D., Abate, K.H. et al. (2018) Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–­2017: a systematic analysis for the Global Burden 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 14 of Disease Study 2017. Lancet, 392(10159), 1923–­1994. Available from: https://doi.org/10.1016/s0140-­6736(18)32225-­6 U.S. Department of Health and Human Services. (2020a) The Surgeon General’s call to action to control hypertension. Available at: https:// www.cdc.gov/bloodp ressu re/docs/SG-­C TA-­H TN-­C ontro l-­Repor t-­508.pdf [Accessed 8 September 2021]. U.S. Department of Health and Human Services. (2020b) The Surgeon General’s call to action to improve maternal health. Available at: https:// orwh.od.nih.gov/sites/orwh/files/docs/call-­to-­action-­maternal-­healt h-­surgeon-­general.pdf [Accessed 8 September 2021]. Virani, S.S., Alonso, A., Aparicio, H.J., Benjamin, E.J., Bittencourt, M.S., Callaway, C.W. et al. (2021) Heart disease and stroke statistics –­2021 update: a report from the American Heart Association. Circulation, 143(8), e254–­e743. Available from: https://doi.org/10.1161/cir.00000 00000000950 Weir, R.C., Proser, M., Jester, M., Li, V., Hood-­Ronick, C.M. & Gurewich, D. (2020) Collecting social determinants of health data in the clinical setting: findings from National PRAPARE Implementation. Journal of Health Care for the Poor and Underserved, 31(2), 1018–­ 1035. Available from: https://doi.org/10.1353/hpu.2020.0075 Whelton, P.K., Carey, R.M., Aronow, W.S., Casey, D.E., Collins, K.J., Dennison Himmelfarb, C. et al. (2018) 2017 ACC/AHA/AAPA/ ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood | 15 pressure in adults: a report of the American College of Cardiology/ American Heart Association Task Force on clinical practice guidelines. Hypertension, 71(6), e13–­e115. Available from: https://doi. org/10.1161/hyp.000000 00000 00065 Williamson, J.D., Pajewski, N.M., Auchus, A.P., Bryan, R.N., Chelune, G., Cheung, A.K. et al. (2019) Effect of intensive vs standard blood pressure control on probable dementia: a randomized clinical trial. JAMA, 321(6), 553–­561. Available from: https://doi.org/10.1001/ jama.2018.21442 S U P P O R T I N G I N FO R M AT I O N Additional supporting information may be found in the online version of the article at the publisher’s website. How to cite this article: Hannan, J.A., Commodore-­Mensah, Y., Tokieda, N., Smith, A.P., Gawlik, K.S., Murakami, L., et al. (2022) Improving hypertension control and cardiovascular health: An urgent call to action for nursing. Worldviews on Evidence-­Based Nursing, 19, 6-­15. https://doi.org/10.1111/wvn.12560 Continuing Professional Development Worldviews on Evidence-Based Nursing is pleased to offer readers the opportunity to earn Continuing Professional Development contact hours for select articles. This opportunity is valid for three years from each article’s date of publication. Learn more here: https://www.sigmamarketplace.org/journaleducation 17416787, 2022, 1, Downloaded from https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12560 by SOUTH TEXAS COLLEGE, Wiley Online Library on [21/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License IMPROVING HYPERTENSION CONTROL AND CARDIOVASCULAR HEALTH: URGENT CALL TO ACTION
